continuing care for my elderly father?

[recompense41]

Hi all,

My 80 year old Father has a history of depression. He was admitted to the local hospital's mental health unit last year for a period of several months. It was then deemed he could cope at home with people coming in from social services twice a day to help him. Initially he was told he'd have to pay for this service and a means assessment was done. After several months and no deductions were made I enquired into this. I was told he didn't have to pay as this came under continuing care from the hospital. It then came to the point that my Father could no longer cope at home and he was found a place in a nearby residential home. He was told by social services he'd have to sell his flat to pay for this as the continuing care would no longer apply. My brother and I did some research and felt the best option would be to apply for deferred payments. That way he would not lose so much equity in his home. We have power of attorney and want what is best for him naturally.

My question is - although he's in a residential home, is he entitled to some help under continuing care? It seems odd that the care in his own home was free yet no aspect of his care in the residential home is. As well as severe depression ( he says he wants to die and lies on his bed all day) he has very bad psoriasis covering most of his body which causes him extreme discomfort. He also has osteo-arthritis in his knees. He is very weak and often has to be helped up into a sitting position.

Any advice would be gratefully received.

[trixter444]

Hi,

Not sure about a residential home but if he is in a nursing home then he can certainly be put forward for the continuing care assessment. Speak to the Matron of the residential home and social services to get the ball rolling.

Good luck

[recompense41]

Thanks for your reply. That's partly where my problem is - the care manger at social services didn't even know about deferred payments and kept insisting that my father's home would have to be sold. Due to that and other instances I don't have much faith in them.

I have raised concerns that I feel he needs to be in a nursing home rather than a residential home due to the level of his problems but social services don't agree.

[trixter444]

Hi recompense

Financially wise, if he has an estate worth more than £20500, then yes it is pretty much standard that to pay for his care the property would have to be sold. However, if he is granted continuing care then thats a different matter, continuing care would pay for his care. Deferred payments usually apply to short term care not long term.

I would contact your social worker and tell them you want to arrange a care review, that way the social worker, yourself and somebody from the home will have a meeting, usually at the home, to discuss what needs he requires and voice any worries you may have. Does he have any alzheimers/dementia at all? Is he mobile?

Trix

[Rob S]

I would take a look at this site for info on the issue of Continuing care:-

NHS funded Continuing Care and the Coughlan case

I am going through the process for my father at the moment. Social services will be keen for the property to be sold to extract as much as possible out of your fathers estate, but the continuing care assessment should be done. One point to investigate is the fact the care was provided while he was living at home so why he doesn't qualify because he is now in a home is odd. If he has been moved into a home then surely his condition has worsened.

[recompense41]

Thank you both for your replies. That website is very useful.

My father has been accepted for deferred payments. Apparently as long as there is enough equity to pay for at least 5 years care then he is eligible even though it is long term. He is only very slightly mobile, using a frame to get from the bed to the toilet etc. He has not been diagnosed with dementia but when I visit he constantly asks what day it is and what time it is and can't remember names of people he has known for decades. His main problem is his severe depression. He is on Lithium and other medication and while he was in the psychiatric unit he was given ECT treatment. He has shown very little if any improvement. He takes no interest in watching the TV, or reading, or associating with the other residents and is constantly lying down.

I will write to the PCT and request an assessment for continuing care. Nothing ventured nothing gained as they say. I feel that the nursing element of his care should be free as it was when he was at home, even if he has to pay the rest for board and lodging etc.

[recompense41]

Not so good tonight - my father seems to have taken a turn for the worse. He's had another fall, the doctor has been out, my father has an infection and is now confused and somewhat delirious. It's very sad.

I wrote to the PCT today to ask for an assessment for continuing care. It's hard having to worry about the finances at the same time as his deteriorating physical condition. But I know many of you are in the same position.

[Rob S]

Recompense,

I know exactly what you mean. It's not easy trying to look after an ailing parent, especially with the agents of the state hovering like vultures trying to get their hands on any assets they can. It disgusts me how the elderly are treated by the local authority and the NHS. They show little compassion for the elderly and seem to view them as a hindrance. They forget how many people of my parents generation had to fight a war to defend us from tyranny, only to have to face it in their twilight years from people who have forgotten the concept of care, compassion and health care from the cradle to the grave.

[recompense41]

I agree. My father has worked hard all his life, never claimed unemployment etc. He cared for my mother when she was dying of cancer and now that he needs care the state seems very uncaring.

I've had a swift response to the letter I posted yesterday. A message has been left on my answerphone to say they will action a review straight away.

[recompense41]

A further update - received a call from the home yesterday evening to say my father had fallen and cut his head and was now at A&E. I went to the A&E as soon as I heard. No-one from the home had come with him in the ambulance. After being admitted around 6pm he finally got a bed on the ward at gone midnight. He didn't need stitches for his cut, but he was even more confused. It's sad that he's fallen (yet again) but maybe the move to the hospital will force the re-assessment and he'll get the care that he so obviously needs. In his state a residential home is not enough.

Would it not have been reasonable for someone from the home to come with him to A & E, at least initially until relatives could get there? He was in no condition to answer all their questions on his own.

[trixter444]

No it is would not have been too much trouble at all to send a carer with your father to hospital, I always ensure a carer goes to hospital with any resident of mine, and that is a rule I have always stuck by. I also ensure that they photocopy all relevent paperwork to take with them to the hospital so the resident isnt asked difficult questions. The resident knows the carer, even with the state of mind your father is in. It is sad that he has fallen again but they will have to reassess him now, he is obviously in need of nursing care not residential, especially being a high falls risk, that should have spoken volumes to social services and the home he is in. have you asked the home why nobody went with your father? My guess is they will say not enough staff on duty to go! I would rather my carers worked short than a resident go to hospital on their own. I am fortunate enough to have very good care assistants who understand their job and the need to do their duty of care for the residents, however I do understand that not all homes are the same.

Keep us updated on how he gets on

Trix x

[recompense41]

Thanks for your reply. I did phone the home yesterday to ask why no-one went with him. They said that was their policy. They also mentioned staffing levels and the fact that the carer would be stranded at the hospital. They did say though that all his information and notes would go with him. The manger did agree that he needs to be reassessed as he has deteriorated quite rapidly.

My father will remain in the hospital at least until Monday. Will keep you updated.

Thanks again. It's good to be able to talk about this.

[trixter444]

What they will most probably do is keep your father in hospital until confirmation of him being nursing has been decided, and then you will probably be asked to go and look at nursing homes within your area and decide on one where they can meet your father's needs the best. It is important to find out what level and category of nursing he is when looking around nursing homes. Some homes do General nursing and EMI nursing, others do just one or the other. Social services should give you a list of homes within your area that will cater for your father's needs, I suggest that before viewing any of them, you ring them up individually to ask if they do that category of care you are looking for otherwise you will have wasted trips to homes that cannot meet his needs.

Let me know how you get on.

Trix x

[recompense41]

Thanks Trix, that's very useful advice.

Will keep you updated as to progress.

Dee

[recompense41]

An update:

I have written to the hospital social services and requested in writing the reason for/criteria used to determine that my father didn't need to pay for care in his own home following discharge from hospital last year.

I have written to the care home and asked for a copy of his care notes/ accident reports.

I hope the response to these will help me in my fight to get continuing care for my father.

He is a little more settled in hospital but still very confused and too frail to get out of bed. I believe an assessment will be carried out today.

[recompense41]

Hello again

I spoke to two people at the hospital yesterday and voiced my concerns regarding my father being returned to the residential home once he is deemed fit enough to leave hospital. They confirmed that he would need nursing care and not residential. They also said he is likely to be in hospital for several weeks while a full assessment is carried out.

While my primary concern is for his health, I'm also trying to safeguard his financial interests. Should I now cancel his placement in the residential home or would that seem rather hasty? I could use the time while he is in hospital to look for possible suitable nursing homes.

[trixter444]

Hi Recompense

Get your social worker involved asap (if they arent already!) and get them to advise you on what category of nursing he is. When you have that info, they should give you a list of nursing homes in your area that you can visit. Give them all a ring when you get the list and check that they do the category of care as it would be a waste of your time to visit homes that dont cater for the care you need. e.g some homes only do general nursing, some only do EMI Nursing, some do both, so it is important to find out what type of nursing he is. Visit as many as you can within your area (you dont usually have to make an appointment if you are looking round a home, just avoid mealtimes). Make notes as you are going round if you wish, take note of the staffing levels to ensure it is well staffed, and all homes are regulated by CSCI - Commission for Social Care Inspection, go on their website and you can view the latest inspection reports of the homes you visit.

Let me know how you get on, hope Ive given you some useful info.

Trix x

[recompense41]

Thanks very much, that's very useful advice. When I visited today I asked again and a hospital care manager will be appointed to him tomorrow. They said he had to be lifted with a hoist today so it looks as though he will need a high level of nursing care. He is not eating and only has energy drinks. His mental state is a great cause for concern too as he has hit a member of the hospital staff ( something he wouldn't dream of normally) and he was talking as though the IRA were out to get him. It's very sad. To be totally frank I'm not sure he'll make it out of the hospital. I will however look at care homes as soon as I know the level he needs.

Thanks again

Dee